Russell Vance is an immunology professor, infectious disease researcher, and the director of UC Berkeley’s Cancer Research Laboratory. By studying the immune system’s response to bacteria that cause tuberculosis and dysentery, Vance hopes to apply those insights into other areas affecting public health, such as cancer.
Vance spoke with UC Berkeley writer Alexander Rony as the federal government was freezing and eliminating many disease research and treatment programs. Vance addressed the ramifications of these changes as well as his hopes for major public health breakthroughs through basic research.
Alexander Rony: How have recent changes to federal programs impacted infectious disease researchers?
Russell Vance: In general, there's a lot of uncertainty about whether the strong track record of funding for basic research in the United States will continue. In particular, funding for infectious disease research seems to be especially vulnerable. Funding to deal with these diseases globally has been very harshly cut.
There was a long list in the New York Times of all the programs that have been cut [editor’s note: some federal cuts are being litigated in court and may be reinstated]. Three million people were getting tuberculosis drugs provided through USAID, and that has been cut. A lot of pregnant women go on prophylactic treatments to prevent transmitting HIV to their fetus, and that has been cut. Bednets to prevent malaria for 50 million people have been cut. As a result, we can anticipate that the progress we were making against these diseases will be reversed. Therefore, these diseases, which were already a big problem, will get worse.
Did you work with any of the eliminated programs?
A little bit. There's a research consortium called Smart4TB, which is on the list of programs being cut. That was in part run through UCSF. People I interact with are supported by these programs.
Vaccines are probably the greatest public health intervention ever devised, and unfortunately they've become politicized. My immediate concerns are for the people who are going to die because they're not getting vaccines. I'm also concerned about my research funding, but that seems like a relatively minor problem compared to the very predictable deaths that will ensue if we stop delivering these vaccines.
How do you stay grounded in your work during this time of upheaval?
What helps me is having been in the field for a while and having the perspective that these things were never going to be solved overnight. We've been battling against tuberculosis for more than a century and progress has been made, but it was always going to be a long struggle. We expect bumps in the road. That's how it goes with these things. In the long view, hopefully, there will be positive news going the other direction. I try to remain optimistic, but this is probably the worst setback for infectious diseases in my career.
You used to teach a course called “Plagues and Pandemics.” That was before COVID. If you could convince policymakers to sit through your course, what would you hope they would take away?
One is that infectious diseases remain a very severe burden on humanity. They haven't been solved. In the United States, we sometimes don't pay that much attention to infectious disease because we're a relatively rich country, and we don't often see the impact. But, globally speaking, the burden is still immense.
The other take-home message is that new threats are always emerging, so we have to prepare. When COVID happened, it wasn't particularly surprising to me, because if you study history, you know some new infectious disease emerges every few years. HIV only really emerged in the 1980s. SARS-CoV-1 caused a serious outbreak in 2003. Before the COVID pandemic, there was a flu pandemic in 2009 that everyone was worried about.
You are affiliated with Berkeley’s Immunotherapeutics and Vaccine Research Initiative. How do cancer research and infectious disease research play off each other?
What ties them together is that the immune system is playing a very important role in both disease processes. The immune system obviously protects against infections, but what has become appreciated more recently is that the immune system also plays a big role in fighting tumors. Whether you're studying it from the perspective of an infection or a tumor, you're still trying to understand the fundamental rules that govern how the immune system works and why it sometimes doesn't.
We have this nice, collaborative group here at Berkeley where I interact with cancer biologists, even though my lab is an infectious disease lab. Those interactions promote this kind of cross-fertilization between fields and allow us to see that some discovery we're making in our lab on infectious disease could be relevant for cancer and vice versa.
That's how discoveries work. You don't set out to cure some particular disease; you set out to answer some basic, curiosity-driven question. Our minds are prepared for when we stumble across something so we can see how it might be important in another context.
Can you describe your research around tuberculosis?
Before COVID, tuberculosis was the biggest infectious disease killer of humans. After COVID, that's still true.
One of the interesting things about tuberculosis is that not everyone infected with the bacteria will come down with the disease. One of the reasons that has emerged to explain why some people are more susceptible than others is that the people who come down with the disease are making an inappropriate immune response. Tuberculosis is a bacterial infection, but it seems some people make an immune response that would be useful if you were fighting off a virus. We're trying to figure out why some people make the wrong kind of response and why that wrong response is actually detrimental. We're trying to figure out interventions that could allow people to make the right kind of response.
This kind of divergent response is true not just of bacterial infections like tuberculosis, but many bacterial infections. It may be broadly relevant in the context of cancer, because the wrong kind of immune response might prevent you from eliminating a tumor.
How is your lab funded?
The work we do is extremely expensive, and it would not be possible without the support of the Howard Hughes Medical Institute and the NIH. With a disease like tuberculosis, which is globally significant and extremely hard to work on, there are a lot of experimental challenges. The bacteria grow very slowly, so experiments take a very long time. It's a Biosafety Level 3 organism [editors note: a lab standard for lethal, airborne pathogens]. We have to do everything in a special, secure laboratory.
There's been a very strong commitment at Berkeley to supporting Biosafety Level 3 research. We were one of the few institutions ready to respond to COVID. These laboratories take years to build — you can't just build them when there's an outbreak — so it's really important to maintain this infrastructure. It's not possible for an individual to run a Biosafety Level 3 lab; you need to have institutional support.
You were featured on two episodes of the popular Discovery Channel show Mythbusters. What can we learn from that program to tackle scientific misinformation?
Obviously, I'm a big believer in science, and part of the reason is because intuition tends to be unreliable. One of the cool things about Mythbusters is that they show that you can prove intuition right or wrong by doing controlled, rigorous experiments. If people could appreciate more how their beliefs might be wrong and that they need to be tested before big decisions, that would be very helpful.
